Reliability of the carousel simulator for assessing labor cervical dilation in medical obstetrics education

• Published in: International journal of gynecology and obstetrics 2024-09, Vol.166 (3), p.1121-1126
• Main Authors: Sartorao‐Filho, Carlos Izaias, Sartorao, Ana Luisa Varrone, Terribile, Diogo Coutinho, Barbosa, Angelica Mercia Pascon, Rudge, Marilza Vieira da Cunha
• Format: Article
• Language: English
• Subjects: gynecology; labor; medical education; obstetrics; simulator
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.15508

Objective To determine the reliability of the Carousel simulator in medical education for obstetric examinations. Cervical dilation examination training in pregnant women exposes patients to additional uncomfortable and health‐risk procedures, a gold standard, and does not objectively evaluate the medical student's competence. Method We studied the reliability of training internship medical students in obstetrics. Participating students were assigned to take the examination of digital assessment of the cervical dilation on the simulator. Classes performed 12 consecutive randomly blind predetermined cervical dilation examinations using the Carousel simulator. The exact answer and the answer with certainty within ±1 cm were registered and analyzed. Incorrect or outlier answers were considered with a cutoff of ≥2 cm from the dilation. A dispersion graph for each centimeter of dilation simulation was constructed. Results Sixty‐six medical obstetricians took part, performing 396 examinations. Thus, we observed 49 outliers (12.37%) in simulated assessments. According to the analysis, we did not observe outliers from dilation 1 to 4 cm; dilation 7 to 9 cm had a higher index of outlier measurements. We did not consider any dilation simulation dispersion graphic as a null correlation. A strong correlation was seen in the dilation 1 to 6 cm and the dilation 10 cm. The dilations 7, 8, and 9 cm showed a weak correlation. Conclusion The Carousel simulator model is a reliable method for student learning. The simulator is an essential study tool capable of reducing the embarrassment and possible harm caused by the excessive and repetitive number of in vivo digital vaginal examinations. Novel studies are proposed to improve the simulator device and method, mainly to estimate the adequate repetitions and training needed before in vivo practice. Synopsis We demonstrated the reliability of a novel simulator device used for digital vaginal examination of cervical dilation during labor for medical education.